| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $987.09 | $987.09 | $987.09 | |
Asuris Northwest Health
| Professional | $1,658.00 | $1,658.00 | $1,658.00 |
Brachytherapy isodose plan; complex (multiplane isodose plan, volume implant calculations, over 10 sources/ribbons used, special spatial reconstruction, remote afterloading brachytherapy, over 12 sources)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $987.09 | $987.09 | $987.09 | |
Asuris Northwest Health
| Professional | $1,658.00 | $1,658.00 | $1,658.00 |